Individual provider Active NPI

Peggy Jean Halsey, CDM, CPM

  • Midwife
  • Wasilla, AK
National Provider Identifier
1891918686
Registry record updated Mar 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
44 Issued in AK
Practice address
2405 S. Knik Goose Bay Road
Wasilla, AK 99654
Phone
(907) 841-2565
Fax
(888) 862-1422
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 44 AK Primary

Addresses

Primary practice location

2405 S. Knik Goose Bay Road
Wasilla, AK 99654

Mailing address

PO Box 874486
Wasilla, AK 99687-4486
Phone (907) 841-2565

Other identifiers 3

IdentifierTypeStateIssuer
1022098MedicaidAK
44OtherAKSTATE LICENSE NUMBER
NM0044MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rejuventate Ak CurrentSince Jul 9, 2023 Accepting new patients
Labor of Love Midwifery, LLC Past Accepting new patients

Locations

2405 S Knik Goose Bay Rd
Wasilla, AK 99654
Phone (907) 841-2565

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520812800000",
    "number": "1891918686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 874486",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996874486",
            "telephone_number": "907-841-2565",
            "fax_number": "888-862-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 S. KNIK GOOSE BAY ROAD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-841-2565",
            "fax_number": "888-862-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALSEY",
        "first_name": "PEGGY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "CDM, CPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2018-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "AK",
            "license": "44",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022098",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "44",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NM0044",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.